This paper aims to identify the range and type of facilitators and barriers to effective management of childhood asthma from the standpoint of rural Ojibwe family caregivers who live on a Midwest reservation. Bronfenbrenner’s ecological model was used to identify facilitators and barriers from a systems perspective. A subset of nine rural, Ojibwe primary family caregivers who have school-aged children with asthma were drawn from the Indian Family Stories Project. This community based research project was developed in collaboration with families, community leaders, and providers using a participatory action research approach. A Native project coordinator conducted semi-structured, in-depth interviews that focused on the family’s cultural background and their experiences caring for their child with asthma in the context of the community. Content analytic strategies were used to identify and categorize facilitators and barriers to asthma management at home, school, and in the community. A broad range of types of barriers (n=47) and facilitators (n=61) were identified. Seven main categories of facilitators were identified: family systems, asthma related resources, health care systems and providers, traditional healing, tribal government, school systems, and environment. Seven main categories of barriers were identified: health care system and providers, asthma related factors, environmental, family, school, socioeconomic, and work. The facilitators reflect the cultural strengths and strong family and community support network that rural Ojibwe family caregivers drew on to help them manage childhood asthma. However, the broad range of barriers indicates the myriad challenges that participants faced in managing their child’s asthma. Implications for nursing practice include: assess the facilitators and barriers that families face in managing asthma; ensure that the child has adults at home, school and the community who are knowledgeable about asthma management; target interventions to reduce family-identified barriers and enhance support networks; and deliver culturally appropriate asthma education and resources that address family-identified needs.
Session #1208 - Family
The 29th Annual MNRS Research Conference (April 1-4, 2005)